NutritionWritten Welsh Assembly Government Statement On Measles And MMR, Wales
The National Public Health Service (NPHS) reports that, as at 17.00 on 15 June 2009, the total number of measles cases in Wales now stands at 302 with 36 people having been hospitalised.
Vaccines are the cornerstone of public health protection, yet the childhood programme is to an extent having to deal with the consequences of its own success. Many parents being asked to vaccinate their children have never seen measles, for example, so have no direct or personal understanding of the damage that the disease can cause. Most accept the advice they have from the NHS but some are still made anxious by information which has since been discredited.
Many grandparents and older community leaders will have some experience of the impact of serious diseases. I would urge them to help support parents in making decisions based on sound science not myths perpetuated through questionable internet websites.
In Wales, we have strong leadership from the National Public Health Service Vaccine Preventable Disease Programme (VPDP) and dedicated local health professionals in LHBs, NHS Trusts and GP practices and pharmacies. They work together on all immunisation programmes to support parents on an individual basis and vulnerable groups such as the homeless, those whose first language is not English, gypsies and travellers. They take opportunities to engage with all those who
can help promote and encourage vaccination. Where uptake is low, additional measures have been put in place such as open clinic sessions and promoting local information messages through free press and on radio. Helping the media to report responsibly is very important as the MMR difficulties have shown us how they can influence public perceptions about childhood vaccination.
I would like to take this opportunity to place on record my thanks for the efforts of all those engaged in delivering immunisation programmes especially at this challenging time.
Since my last statement, I have been considering carefully several issues compulsory vaccination, a possible study into parental attitudes in outbreak areas and engagement about immunisation generally.
Calls have been made for compulsory MMR immunisation on the grounds that it would ensure that all children in Wales would be protected against the three diseases for life. The rising number of measles cases necessitated a fresh look at compulsory MMR vaccination and this has been undertaken. My conclusion is that compulsion would adversely affect the trust that most parents have in local health professionals. It would give rise, inevitably, to issues of compulsion and actions which would have to be taken to deal with those who refuse to comply with compulsion. It would, on the advice I have received, make matters worse, not better. I think our efforts must therefore continue to be on providing parents with reassurance based on sound scientific evidence and medical advice and I am confident that, on that basis we will reach again the level of MMR vaccination needed to provide general immunity.
It has been suggested that some research might be undertaken in the outbreaks areas to better understand the reasons behind decisions not to vaccinate children with the MMR vaccine. I have given much thought to this as I recognise the sensitivities involved at a time when the measles outbreak is on-going. I do not rule out such research once the outbreak is at an end, because I believe that valuable insights are likely be drawn from the direct experience of parents involved.
I have been considering whether an information campaign about all childhood vaccines including MMR is needed. A new measles leaflet has already been distributed to GP practices, pharmacies and NHS trusts. Existing leaflets have now gone to all secondary schools in Wales to supplement the initial re-distribution in outbreak areas. These materials will support local efforts to boost vaccination uptake.
Nevertheless, I am persuaded that a new campaign is needed, particularly in the wider context which swine flu creates, and the need to ensure that we promote, again, the benefits of vaccination against seasonal flu this autumn. My intention is to develop a new, national leaflet, provided to every household in Wales, which will build on the confidence which most parents and patients have in the information they receive, and reinforce the messages about the importance of vaccination in current circumstances. The leaflet will cover MMR vaccination, but go beyond it to provide information about vaccination in other areas, too. All of this will, of course, be in addition to the work which is still going on, through health professionals directly involved in immunisation and also through partner organisations who have influence to bear. Work is already proceeding, for example, to ensure that standard guidance on registration procedures for nurseries includes questions about the child"s vaccination status and includes a new emphasis on the importance of being up to date with routine vaccines.
Efforts are also being made to encourage colleges and universities to make available the MMR leaflet to existing and new students and to use electronic communications with new students to provide reminders about the importance of immunisation.
More generally, NHS reorganisation has provided the ideal opportunity for LHBs to strengthen their ability to deliver vaccination services and meet all requirements including the 95% target for both MMR doses. By October 2009, each LHB should have in place a dedicated post with the role of co-ordinating the implementation of immunisation policy, maximising existing services and training provision in primary and community care and hospital settings. These co-ordinators will be working closely with a dedicated lead nurse and lead doctor for immunisation.
MMR uptake has been increasing slowly and steadily since the low point of 77% in 2003. In my last statement, I reported that the latest COVER data showed that uptake of the first dose of MMR in two year olds was 89.6%. Progress is being made and there is a concerted effort to respond to the measles outbreaks and allay the fears of concerned parents. I am confident that the actions outlined in this statement will assist in raising MMR uptake to the 95% target level.
Welsh Assembly Government